Doctors make for good television. Networks have been filling their primetime lineups with medical dramas for as long as TV has been around. Sometimes the focus changes, from medical mysteries like House or Quincy, M.E., to the drama of emergency medicine like ER, or the complex relationships and realities of working in a hospital setting like Grey’s Anatomy. But from comedy to drama, historic or present day, TV has always included a constant stream of programming portraying doctors as heroes.
“TV writers are trying to capture drama and emotion, and the things doctors deal with every day are a perfect fit for that,” observed Jules Lipoff, MD, an assistant professor of Clinical Dermatology.
Lipoff spends his days working as a physician, but he’s also someone who appreciates the craft of putting together an entertaining episode of television. His passions include creative writing and screenwriting. While studying as an undergrad, he ran a humor magazine and interned at The Onion. Even now, in between seeing patients and working on research, he has taken multiple classes at Penn in things like screenwriting, filmmaking, and the art and business of cinema.
“It wasn’t something I planned to pursue as a career,” Lipoff said. “I was always drawn to medicine because it can make such a direct impact on people’s lives.”
Still, Lipoff says he’s come to appreciate the impact that writing can have, too. At times, he’s combined his professional life with his hobby and waded into the medical mysteries of fiction and lore, laying out theories in Vox on the possible causes of Game of Thrones’ greyscale disease that turns men to stone, or delving into the real life medical conditions that could explain common legends like vampires, werewolves, and zombies for the Philadelphia Inquirer.
With expertise in the realities of medicine combined with the serious fan cred of a well-studied pop culture junkie, Lipoff has a pretty good handle on what makes for a good medical show. First, he says, it’s important to remember these shows are entertainment first, which means you can’t get too nitpicky about all the details being accurate.
“These shows must make the drama of the medical world entertaining and interesting, “Lipoff said. “After writers have gotten people into that world, then they can explore more serious issues, but you can’t lead with them. It’s a select audience that will watch things that are super serious, unless the show is really good, like The Wire.”
While The Wire was a critical darling, the ratings bear out Lipoff’s point. The show, which took an ultra-realistic look at the Baltimore drug trade and the culture of cops, politics, unions, schools, and newspapers in a big city, is widely regarded as one of the best series in the history of television. But while it has found its audience after the fact, it never drew the kind of widespread crowds during its initial run that a network drama needs.
“You could try to make The Wire of medicine, but it would take so much work and there’s no guarantee of success,” Lipoff said.
In fact, Lipoff points out what an advantage it can be to start on the complete opposite end of the spectrum. He points to the show Scrubs, a screwball comedy that used its humor as a way to bring people into the world of its medical drama.
“You can capture a lot of the gallows humor, the dark humor of dealing with life and death and disease, and yet remain optimistic and be earnest about trying to do good in the world,” Lipoff said.
He also noted how much the show had to say about the culture of the medical world, and specifically mentioned an episode that portrayed doctors and surgeons as rival gangs in a West Side Story parody.
“There’s a way you can use comedy to show things like that, that if you tried to show them literally, it wouldn’t quite ring true,” Lipoff said.
For shows that do keep it serious, Lipoff says he’s usually drawn to stories that try to tackle real world issues. He pointed to The Knick, a Cinemax drama set in a New York City hospital in the early 1900s.
“It was fascinating to see a depiction of medicine in its infancy,” Lipoff said of the show. “It makes you appreciate what we have today. We don’t realize how much medicine has evolved in 100 years.”
With a full-on comedy and a historical drama representing the poles of what medical shows can be, the truth is that the bulk of the shows people know fall somewhere in between. Shows like Grey’s Anatomy are a common example of how a medical backdrop can both explore true medical conundrums, but also simply be a vehicle to tell the stories of personal drama among the characters. When medical events do become plot points, Lipoff says it makes a better story to exaggerate how certain things would happen in the real world, or to simplify things to the point where they may be inaccurate. He used the example of a doctor performing an emergency tracheotomy, something that’s come up in countless TV episodes but is relatively rare, at least in the context of the way most shows portray it.
But even in those cases, Lipoff says it still represents an opportunity to engage audiences by the millions on medical issues in a way that would be impossible to accomplish with academic medical writing. Academia can still help TV get it right. Programs like the University of Southern California’s Hollywood, Health, and Society program is focused on providing accurate information to the entertainment industry for storylines that are ripped from the headlines. But in the end, Lipoff says the key for all of these shows, he says, is for the emotion to feel genuine. He says it’s one of the strongest factors in a show like ER.
“You saw doctors struggling, and you saw that this wasn’t an easy job,” Lipoff said. The characters were more human than superhero, and the audience was more invested as a result.
As for Lipoff, he’s content to take his doctor hat off once he turns the TV on. Between his studies and experiences, he says he has a new appreciation for how difficult it is to make these shows, but plans to keep exploring his creative passions wherever he can, including consulting for TV.
“I’m embracing the millennial attitude of constantly trying to grow and learn and evolve in my career and not trying to be obsessed with where it will lead,” Lipoff said. “I just want to enjoy the process.”